Provider Demographics
NPI:1104282045
Name:COLETTE T. SCHEUERMANN
Entity type:Organization
Organization Name:COLETTE T. SCHEUERMANN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:SCHEUERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-359-7917
Mailing Address - Street 1:8047 TAUREN CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7718
Mailing Address - Country:US
Mailing Address - Phone:847-359-7917
Mailing Address - Fax:847-359-7917
Practice Address - Street 1:8047 TAUREN CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119
Practice Address - Country:US
Practice Address - Phone:847-359-7917
Practice Address - Fax:847-359-7917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149003493101YM0800X
FLSW13074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1014M0800XMedicaid